Online Forms

McDaniel Chiropractic Center offers our patient form(s) online so you can complete it in the convenience of your own home or office.

• If you do not already have AdobeReader® installed on your computer, Click Here to download.
• Download the necessary form(s), print it out and fill in the required information.
• Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Health History Form - Required

This let’s us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download Health History Forms

New Patient Pain & Daily Activities Assessment-Required

Let us know what your pain has been like and if you are having difficulty doing your daily activities.  Please choose from one or more of the following forms that apply to your complaint(s):

Low Back Condition Assessment Form

Neck Condition Assessment Form

Other Conditions Assessment Form

New Patient Offer

Download a Coupon for a Discount off of your initial visit in our office!

Reactivating Patient Update Form

If you are a current patient and there has been a lapse in your care in our office, we require an Update Form to re-establish your care and document medical necessity.  If you have not had an appointment in three years or more you will need to fill out the New Patient History forms above.

Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download the Free AdobeReader®